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Hospitals deal with different challenges: reducing costs, a shortage of skilled employees, implementing digital workflows, or data privacy issues. Depending on the country, different approaches and strategies come into play. We took a closer look at the healthcare industries in Denmark, the Netherlands, Germany, France, and Switzerland.
Scandinavia set the course early on for the construction of so-called super hospitals: a fundamental restructuring at organizational level. By expanding specialties, focusing on acute treatments and fewer hospitalizations and investing in e-health, the state authorities are aiming to improve efficiency and the quality of care while cutting costs.
Let's pick Denmark as an example: Since 2007, Denmark has undergone a major reform in its healthcare system, that focuses on modernizing the clinical landscape. This had an effect throughout Scandinavia. The reform saw the transformation of small clinics into large, advanced super hospitals that compete with each other through rankings and profitability calculations to attract patients both within and outside of Scandinavia.
The facilities are equipped with the latest medical IT and building technology. They strive to provide top-notch care for patients as efficiently as possible. Solutions that promise to increase efficiency or offer patient support are readily adopted by clinics, as they are particularly encouraged by government investment. The fact that e-health and digitization are part of everyday life at the new super hospitals in Scandinavia is evident in both equipment and patient care. This can be seen, among other things, in the average length of stay for Danish hospital patients, which at 3.7 days, is the shortest of all EU countries. In Germany, by comparison, the average is twice as long at 7.2 days.
Public hospitals in the Netherlands compete with private institutions. State-of-the-art technologies and first-class treatment are supposed to attract patients. Thus, digitization and automation solutions play a crucial role in the Dutch hospital landscape.
For years, the Netherlands have been making targeted investments in the digitization of medicine, care and digital patient self-services. Such investments are possible because prescribing therapy digitally and storing data electronically have also been a standard for many years. These measures reduce healthcare costs and increase the quality of care – and they are specifically subsidized by the Dutch government.
Along with many other countries, the Netherlands are also facing a labor shortage. In 2023, further investments of 130 million euros are planned, aimed at reducing the workload on healthcare staff and making the healthcare profession more appealing to potential workers.
Let’s move on to the direct neighbor, Germany. By international comparison, the country spends very large resources on health. In return, Germans receive very good system access and a high volume of health care services. However, the quality of care often only ranges in the middle of the OECD countries.
The share of public facilities in Germany is steadily declining, from 44.6% (1992) to 29% (2020). More and more municipalities or federal states are selling their facilities to private, for-profit companies. Their share has increased from 15.5% (1992) to 38.5% (2020). In terms of the number of beds, public facilities still account for the largest share - with a downward trend - of the 650,167 beds in Germany (in 2020).
Unlike the Nordic countries, digitization presents significant challenges for the German hospital landscape. In particular due to an outdated or missing IT infrastructure, strong data protection regulations, and a high degree of bureaucratic processes in public healthcare facilities. Additionally, unified centralized approaches are not easy to implement because of the very decentralized clinical landscape. However, a trend in inpatient drug supply is visible: central pharmacies supply the main hospital and some satellite facilities. In parallel, the pharmacy association promotes centralized repackaging in unit doses within a closed loop medication management.
In France, the public sector accounts for approximately 85 % of the hospital market, while the private sector accounts for 15 %. And, the French hospital landscape also shows a large number of hospital beds (386.918 in 2020), with most beds located in larger, specialized hospitals. Looking at this number, a decline of 7.15% is visible from 2010 to 2021, whereas in Germany the number of beds dropped by only 3.6%.
In terms of digitization and automation, French hospitals are more advanced than their German counterparts. Particularly in the introduction of electronic health records and health information exchange they are quite advanced, but still, they are not on the same level as the Scandinavian countries and the Netherlands. This is related to the size and complexity of the French healthcare system.
However, the trend goes towards higher investments for technology and digitization with the primary targets
Guiding healthcare professionals along these changes will be a challenge for French hospitals.
On inpatient drug supply, hospitals in France are moving toward a centralized approach within their drug supply, which is handled by central pharmacies. As in Germany, the unit dose approach is increasingly coming into focus.
Last but not least: Switzerland. Switzerland's healthcare system is predominantly publicly owned, with a small but growing private sector. While professionals predict that Switzerland will eventually adopt the Dutch and Scandinavian models, fundamental reforms have not yet been announced. Switzerland's hospital system is widely regarded as one of the best in the world, but its high expenditures have put pressure on the country to reduce costs.
Swiss hospitals have already performed various actions:
Swiss hospitals are placing a greater emphasis on ambulatory care and reducing the length of inpatient stays. This shift is aimed at improving the quality of care and reducing costs. Furthermore, hospitals are moving towards centralizing their drug supply through a central pharmacy that delivers to both inpatient and outpatient pharmacies.
Nevertheless, the high cost of digitalization and technology upgrades are sometimes a challenge, especially for public hospitals that are facing budget constraints. On top of that, ensuring secure storage and management of sensitive patient data is challenging considering stricter data protection regulations. Like almost every European country, Switzerland is also dealing with a labor shortage. This can limit the technological and digital progress in terms of skills, innovations and changes.
This journey across the healthcare landscape in Europe deepens the understanding for the diverse challenges and innovate solutions in each country. By comparing and adopting best practices from other nations, healthcare systems can be improved to provide better care for citizens.
One of the key takeaways from this evaluation is the importance of digitalization in healthcare. As we face labor shortages across Europe, investing in digital and automated solutions will be essential to enhance efficiency and reduce costs. Ultimately, this will enable us to prioritize patient care and improve recovery outcomes.
At the heart of every consideration: the patients. By implementing forward-thinking measures an embracing digital transformation, we can create a more patient-centered and sustainable healthcare landscape today and for the generations to come.
